Mức độ tuân thủ điều trị thuốc chống loãng xương đường uống theo thang điểm GMAS ở phụ nữ sau mãn kinh

Abstract

Osteoporosis is a silent progressive skeletal disorder that is often diagnosed later, frequently after the occurrence of fragility fractures; treatment is long-term and achieves optimal effectiveness only when patients adhere to therapy. Therefore, we conducted this study to evaluate adherence to oral anti-osteoporosis medication using the General Medication Adherence Scale (GMAS) and to investigate associated factors among postmenopausal women with primary osteoporosis receiving outpatient treatment at Hanoi Medical University Hospital. A cross-sectional descriptive study was conducted on 220 postmenopausal women diagnosed with primary osteoporosis according to the American Association of Clinical Endocrinology 2020 criteria, who were receiving oral bisphosphonate therapy. Medication adherence was assessed using the 11-item GMAS, which classifies adherence into four levels. The results showed that the mean GMAS score was 23.12 ± 6.97, corresponding to a moderate level of adherence, while 62.27% of patients were classified as having moderate-to-poor adherence. The two items with the highest mean scores were ‘uncertainty regarding the timing/method of medication administration’ and ‘discontinuation of medication due to inadequate understanding of its proper use’, indicating that most patients reported relatively few difficulties in these aspects. In contrast, lower scores were observed in items related to forgetting medication and stopping treatment when symptoms improved, reflecting more common non-adherent behaviors. Multivariable logistic regression analysis revealed that rural residence, menopause duration ≥ 10 years, osteoporosis diagnosis duration < 1 year, experiencing adverse drug reactions, and medication use duration < 6 months were independently associated with moderate-to-poor adherence. These findings highlight the need to strengthen patient counseling, follow-up, and adherence support from the initiation of therapy.